By Dr Judy Todd, NHS anaesthetist and aesthetics expert

"PAIN is beauty”, but when carried out correctly, it doesn’t need to be. With advances in cosmetic medicine and aesthetic procedures saturated on social media, looking and feeling our best is not only the easiest, but the riskiest it has ever been.

Looking and feeling good has never been more prevalent and with a generation of young people focused on eating well and going to the gym, should their healthy lifestyles be matched with the latest “pouty” lip or slimmed down nose?

Scotland seems to think so, with the number of people undergoing aesthetic procedures at an all-time high with an estimated four per cent of Scottish adults (217,000) admitting to having undergone a private cosmetic treatment.

What cost are we willing to pay for this idea of “beauty” today?

With any expanding market there is always going to be demand for cheaper prices and easier access, a lot of which can be attributed to social media.

Young people now aspiring to the beauty standards set by TV programmes such as Love Island or Towie, which not only set an unrealistic image of beauty but also income and lifestyle. As a result, millennials are chasing an often unaffordable lifestyle and making alterations to their body to mirror those on screen.

As a consequence, a number of unscrupulous and under-qualified clinics are popping up offering cut-price treatments that compromise patient safety, lead to poor results and take advantage of patient’s naivety to legal healthcare standards.

It is usually this group of practitioners who are not experienced enough to successfully perform the procedures or treat complications, and that is when things can get ugly.

The human face is extremely complex and to be able to carry out cosmetic treatments safely, you need to have intimate knowledge of the nerves and blood vessels and how the delicate skin on the face ages.

What is most concerning is the current trend of under-qualified people offering procedures such as non-surgical nose jobs or lip fillers, treatments which are quick fixes and appealing to this younger generation of appearance-savvy individuals.

I have even heard of pop-up clinics of non-medical or nursing practitioners offering this here in Scotland and what is worrying is how these people are acquiring the injectables for such treatments. Injectables (also known as botox) is a prescription-only medicine, issued after a consultation with a doctor or qualified prescriber.

Unfortunately, Healthcare Improvement Scotland (HIS) and the law are slow to respond to this practice. The current HIS status only covers practitioners such as dentists and nurses but allows unqualified practitioners, free rein, and unaccountable for the consequences, should it go wrong.

Extended role pharmacists with prescribing privileges are also enabling underqualified people access to medical devices (fillers) and drugs (Botox and Aqualux). This prescribing-extended role was developed initially and intended for them to be able to treat and prescribe for minor illnesses, thereby unburdening GPs. It is an abuse power that certain Pharmacists are enabling beauty therapists to do Botox, fillers and even more worryingly in some cases “fat dissolving injections”.

Criminalising the cowboys, the way it has for healthcare professionals, should be the main focus of its work on patient safety. In the meantime, the only safe option is going to an experienced doctor, dentist or nurse for any cosmetic medical treatment. Allowing people with no clinical knowledge or training to carry out procedures could be a public health disaster in the making.

You can check if your independent clinic is registered with Healthcare Improvement Scotland at www. and and find out more about treatments from Dr Judy Todd at Synergy Giffnock: